胰高血糖素样肽-1受体激动剂对2型糖尿病合并动脉粥样硬化性心血管疾病患者血管危险因素的影响

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2025-01-08 DOI:10.1016/j.ajpc.2024.100922

Aaron King , Xi Tan , Neil Dhopeshwarkar , Rhonda Bohn , Katherine Dea , Charles E. Leonard , Adam de Havenon

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引用次数: 0

摘要

在现实世界的实践中，关于每周一次（OW）胰高血糖素样肽-1受体激动剂（GLP-1 RAs）心血管有效性的数据有限。方法：我们评估OW GLP-1 RA对成人2型糖尿病和动脉粥样硬化性心血管疾病患者血管危险因素的影响，使用来自美国大型电子健康记录数据库的数据（索引日期= OW GLP-1 RA的首次处方）。探索性分析了新启动的OW GLP-1 RAs患者与semaglutide， OW GLP-1 RAs没有semaglutide和semaglutide。血管危险因素的变化通过比较指数前后12个月的平均值来评估。对所有三个队列和亚群进行了分析，包括按基线血管危险因素值的不育分层。结果：在最终队列中([1]OW GLP-1 RA包括semaglutide: n = 20,084；不含semaglutide的GLP-1 RA: n = 16,894；[3] semaglutide: n = 3,435)，从基线到指数后，血红蛋白A1c (%, [3] -1.1；[2] -1.1;[3] -1.2)，低密度脂蛋白胆固醇(mg/dL, [3] -6.4；[2] -6.4;[3] -6.9)，总胆固醇(mg/dL, [3] -11.0；[2] -11.1;[3] -10.7)，甘油三酯(mg/dL, [3] -31.8；[2] -31.4;[3] -33.1)，收缩压(mmHg, [3] -1.5；[2] -1.2;[3] -3.1)，体重(kg, [3] -2.7；[2] -2.4;[3] -4.3)和体重指数(kg/m2；[1] -0.9;[2] -0.8;[3] -1.4)。减少幅度最大的是顶端。结论：我们的数据表明，在现实生活中，GLP-1 RAs与关键血管危险因素的显著降低有关。

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Effect of glucagon-like peptide-1 receptor agonists on vascular risk factors among adults with type 2 diabetes and established atherosclerotic cardiovascular disease

Introduction

Limited data exist on the cardiovascular effectiveness of once-weekly (OW) glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in real-world practice.

Methods

We assessed the OW GLP-1 RA effects on vascular risk factors in adults with type 2 diabetes and atherosclerotic cardiovascular disease using data from a large-scale US electronic health record database (index date = first prescription of OW GLP-1 RA). Exploratory analyses were performed on patients newly initiating OW GLP-1 RAs with semaglutide, OW GLP-1 RAs without semaglutide, and semaglutide. Changes in vascular risk factors were evaluated by comparing mean measures between the 12-month pre- and post-index periods. Analyses were conducted for all three cohorts and subpopulations including stratified by tercile of baseline vascular risk factor value.

Results

In the final cohorts ([1] OW GLP-1 RA including semaglutide: n = 20,084; [2] OW GLP-1 RA excluding semaglutide: n = 16,894; [3] semaglutide: n = 3,435), significant mean reductions (P < 0.001) were observed from baseline to post-index in hemoglobin A1c (%, [1] -1.1; [2] -1.1; [3] -1.2), low-density lipoprotein cholesterol (mg/dL, [1] -6.4; [2] -6.4; [3] -6.9), total cholesterol (mg/dL, [1] -11.0; [2] -11.1; [3] -10.7), triglycerides (mg/dL, [1] -31.8; [2] -31.4; [3] -33.1), systolic blood pressure (mmHg, [1] -1.5; [2] -1.2; [3] -3.1), body weight (kg, [1] -2.7; [2] -2.4; [3] -4.3) and body mass index (kg/m²; [1] -0.9; [2] -0.8; [3] -1.4). Largest reductions were observed in the top tercile.